HomeMy WebLinkAbout39182-ZNo:
Town of Southold Annex
P.O. Box 1179
r 54375 Main Road
i Southold, New York 11971
CERTIFICATE OF OCCUPANCY
1/13/2015
37381 Date: 1/13/2015
THIS CERTIFIES that the building ADDITION/ALTERATION
Location of Property: 75 Deer Run, Southold,
SCTM #: 473889 Sec/Block/Lot: 79.4-17.22
Subdivision: Filed Map No. Lot No.
conforms substantially to the Application for Building Permit heretofore filed in this office dated
9/9/2014 pursuant to which Building Permit No. 39182 dated 9/15/2014
was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for
which this certificate is issued is:
ROOF STRUCTURE OVER AN EXISTING PATIO TO A ONE FAMILY DWELLING AS APPLIED FOR
The certificate is issued to Butkovich, Ronald & Butkovich, Margaret
(OWNER)
of the aforesaid building.
SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL
ELECTRICAL CERTIFICATE NO.
PLUMBERS CERTIFICATION DATED
39182
01-12-2015
12
Y
�AVrizeoignatdre
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 39182 Date: 9/15/2014
Permission is hereby granted to:
Butkovich, Ronald & Butkovich, Margaret
75 Deer Run
PO BOX 571
NY 11971
To: Roof structure over an existing patio as applied for.
At premises located at:
75 Deer Run, Southold
SCTM # 473889
Sec/Block/Lot # 79.-4-17.22
Pursuant to application dated
To expire on 3/16/2016.
Fees:
9/9/2014
and approved by the Building Inspector.
SINGLE FAMILY DWELLING - ADDITION OR ALTERATION
CO - AD I'I'InN TO DWELLING
$325.20
$50.00
1
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN CLERK'S OFFICE
,5;
SOUTHOLD, NY
BUILDING PERMIT
(THIS PERMIT MUST BE KEPT ON THE PREMISES
WITH ONE SET OF APPROVED PLANS AND SPECIFICATIONS
UNTIL FULL COMPLETION OF THE WORK AUTHORIZED)
Permit #: 39182 Date: 9/15/2014
Permission is hereby granted to:
Butkovich, Ronald & Butkovich, Margaret
75 Deer Run
PO BOX 571
NY 11971
To: Roof structure over an existing patio as applied for.
At premises located at:
75 Deer Run, Southold
SCTM # 473889
Sec/Block/Lot # 79.-4-17.22
Pursuant to application dated
To expire on 3/16/2016.
Fees:
9/9/2014
and approved by the Building Inspector.
SINGLE FAMILY DWELLING - ADDITION OR ALTERATION
CO - AD I'I'InN TO DWELLING
$325.20
$50.00
1
Form No. 6
TOWN OF SOUTHOLD
BUILDING DEPARTMENT
TOWN HALL
765-1802
APPLICATION FOR CERTIFICATE OF OCCUPANCY
This application must be filled in by typewriter or ink and submitted to the Building Department with the following:
A. For new building or new use:
1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or
topographic features.
2. Final Approval from Health Dept. of water supply and sewerage -disposal (S-9 form).
3. Approval of electrical installation from Board of Fire Underwriters.
4. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead.
5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate
of Code Compliance from architect or engineer responsible for the building.
6. Submit Planning Board Approval of completed site plan requirements.
B. For existing buildings (prior to April 9, 1957) non -conforming uses, or buildings and "pre-existing" land uses:
1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic
features.
2. A properly completed application and consent to inspect signed by the applicant. If a Certificate of Occupancy is
denied, the Building Inspector shall state the reasons therefor in writing to the applicant.
C. Fees
1. Certificate of Occupancy - New dwelling $50.00, Additions to dwelling $50.00, Alterations to dwelling $50.00,
Swimming pool $50.00, Accessory building $50.00, Additions to accessory building $50.00, Businesses $50.00.
2. Certificate of Occupancy on Pre-existing Building - $100.00
3. Copy of Certificate of Occupancy - $.25
4. Updated Certificate of Occupancy - $50.00
5. Temporary Certificate of Occupancy - Residential $15.00, Commercial $15.00
Date.
New Construction: Old or Pre-existing Building: (check one)
Location of Property: % ce /,– i�LL 1c�,
House No. Street Hamlet
Owner or Owners of Property: O v) ca oLPI6u,}k vac
Suffolk County Tax Map No 1000, Section 7 Blo Lot
Subdivision Filed Map. Lot:
Permit No. Date of Permit. Applicant:
Health Dept. Approval: Underwriters Approval:
Planning Board Approval:
Request for: Temporary Certificate Final Certificate: (check one)
Fee Submitted: $
Applicant Signature ��—
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
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Telephone (631) 765-1802
Fax (631) 765-9502
roger. riche rt(aD-town.southoId. ny. us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
CERTIFICATE OF ELECTRICIAL COMPLIANCE
SITE LOCATION
Issued To: Ronald Butkovich
Address: 75 Deer Run City: Southold St: NY Zip: 11971
Building Permit* 39182 Section: 79 Block: 4 Lot: 17.22
WAS EXAMINED AND FOUND TO BE IN COMPLIANCE WITH THE NATIONAL ELECTRIC CODE
Contractor: DBA: G&S Electric License No: 578-e
Residential
Commerical
New
Addition
X
Indoor
Outdoor
Renovation
Survey
Duplec Recpt
3
SITE DETAILS
Office Use Only
Basement
X 1st Floor
2nd Floor
Attic
INVENTORY
Service Only
Pool
Hot Tub
Garage
Service 1 ph
Heat
Duplec Recpt
3
Ceiling Fixtures
HID Fixtures
Service 3 ph
Hot Water
GFCI Recpt
1
Wall Fixtures
2
Smoke Detectors
Main Panel
A/C Condenser
Single Recpt
Recessed Fixtures
CO Detectors
Sub Panel
A/C Blower
Range Recpt
Fluorescent Fixture
Pumps
Transformer
Appliances
Dryer Recpt
Emergency FixtureSH
Time Clocks
Disconnect
1-1
Switches
Twist Lock
El
E)dt Fixtures
TVSS
Other Equipment:
REAR PORCH, 2 -paddle fans
Notes:
Inspector Signature: Date: Jan 12 2015
81 -Cert Electrical Compliance Form.xls
eTo
WN F
O SOUTHOLD BUILDING DEPT.
765-1802
INSPECTION
FOUNDATION 1 ST [ ] ROUGH PLUMBING
FOUNDATION 2ND
[ ]INSULATION
[ ] FRAMING /STRAPPING [ ] FINAL
[ ] FIREPLACE A CHIMNEY [ ] FIRE SAFETY INSPECTION
] FIRE RESISTANT CONSTRUCTION [ ] FIRE RESISTANT PENETRATION
ELECTRICAL (ROUGH) [ ] ELECTRICAL (FINAL)
[ ] CODE VIOLATION [ ] CAULKING
REMARKS:
DATE f INSPECTOR
�o,\\pf SOUr,�O
TOWN OF SOUTHOLD BUILDING DEPT.
765-1802
INSPECTI
[ ] FOUNDATION 1 ST [
[ ] FOUNDATION 2ND [
( ] FRAMING / STRAPPING [
[ ] FIREPLACE A CHIMNEY [
[ ] FIRE RESISTANT CONSTRUCTION [
[ ] ELECTRICAL (ROUGH) [
[ ] CODE VIOLATION , [
REMARKS:
r"A
vz t- .6'-3 L,,\. , J& -J,
t
RO H PLUMBING
] tWSULATION
FINAL
] FIRE SAFETY INSPECTION
] FIRE RESISTANT PENETRATION
] ELECTRICAL (FINAL)
] CAULKING ^
6jb
69 (E-2
SECB
PROFESSIONAL ENGINEER
1725 HOBART ROAD / PO Box 616 SOUTHOLD, NEW YORK 11971
TEL: 631.765.2954 • FAX: 631.614.3516 • e-mail: joseph@fischetti.com
Date: 10 December 2014
Reference: 75 Deer Run - BP#39182Z
Building Inspector
Town of Southold
Main Road, Southold, NY
Dear Sir,
For the home at 75 Deer Run in Southold, I certify to the best of my knowledge and experience
that the footings, framing and strapping were installed in accordance with my designs and to
New York State Building Codes.
Deer mn certification for Bertani.do BOARD CERTIFIED IN STRUCTURAL ENGINEERING
�IDEC 1 1 2014
i
T, )
FOUNDA110N (1ST)
FOUNDATION (2ND)
ROUGH FRANWQ &
PLUMBING
INSUL• A.TION PER N. Y.
STATE ENERGY CODE
FINAL
I1?ENTS '
'rOWi* OF SOUTHOLD
R ILDING DEPARTMENT
TOWN HALL
BUILDING PERMIT APPLICATION CHECKLIST
SOUTHOLD, NY 11971
TEL: (631) 765-1802
FAX: (631) 765-9502
South oldTown.NorthFork.net PERMIT NO.
Examined S 20___��
Approved 9.1(s—,20_��
Disapproved a/c /
Expir ion 20J
Li' SEP - 8 2014
CATION FOR BUILDING
INSTRUCTIONS
Do you have or need the following, before applying?
Board of Health
4 sets of Building Plans_
Planning Board approval
Survey
Check
Septic Form
N.Y.S. D. E. C.
Trustees
C.O. Application_
Flood Permit
Single & Separate
Storm -Water Assessment Form
Contact:
Mail to:
Phone:
Date ti- , 20 IL(
a. This application MUST be completely filled in by typewriter or in ink and submitted to the Building Inspector with 4
sets of plans, accurate plot plan to scale. Fee according to schedule.
b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public streets or
areas, and waterways.
c. The work covered by this application may not be commenced before issuance of Building Permit.
d. Upon approval of this application, the Building Inspector will issue a Building Permit to the applicant. Such a permit
shall be kept on the premises available for inspection throughout the work.
e. No building shall be occupied or used in whole or in part for any purpose what so ever until the Building Inspector
issues a Certificate of Occupancy.
f. Every building permit shall expire if the work authorized has not commenced within 12 months after the date of
issuance or has not been completed within 18 months from such date. If no zoning amendments or other regulations affecting the
property have been enacted in the interim, the Building Inspector may authorize, in writing, the extension of the permit for an
addition six months. Thereafter, a new permit shall be required.
APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the
Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or
Regulations, for the construction of buildings, additions, or alterations or for removal or demolition as herein described. The
applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit
authorized inspectors on premises and in building for necessary inspections.
oil���i�,11�e.-y
(Signature of applicant or name, if a corporation)
l 3Fo
(Mailing address of applicant) ttc{-1 t
State whether applicant is owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or builder
tp-- -
Name of owner of premises Kwa &,k & cLn 6L- M
(As on tlo
If applicant is a corporation, signature of duly authorized officer
(Name and title of corporate officer)
Builders License No.
Plumbers License No.
Electricians License No.
Other Trade's License No.
1. Location of
House Num
on which proposed work will be done:
Street
roll or latest deed)
error
�Ov-`�-�� t � 'jf I��c1S ltd ✓e�,
Hamlet
County Tax Map No. 1000 Section 9 °\ Block H Lot 1TF:2::e
Scott A. Russell U*1
`]F01KM WA,]F1E1K
SUPERVISOR C �Tl��l[A\1� A\ G�]EI��1[]E1�'7C'SOUTHOLD TOWN HALL - P. O. Box 1179 53095 Main Road - SOUTHOLD, NEW YORK 11971 Town of Southold
CHAPTER 236 - STORMWATER MANAGEMENT WORK SHEET
( TO BE COMPLETED BY THE APPLICANT)
DOES THIS PROJECT INVOLVE ANY OF THE ]FOLLOWING:
Yes I No (CHECK ALL THAT APPLY)
A. Clearing, grubbing, grading or stripping of land which affects more
than 5,000 square feet of ground surface.
B. Excavation or filling involving more than 200 cubic yards of material
/ within any parcel or any contiguous area.
100 feet of horizontal distance.
❑13""D. Site preparation within 100 feet of wetlands, beach, bluff or coastal
erosion hazard area.
❑[3-'E. Site preparation within the one -hundred -year floodplain as depicted
on FIRM Map of any watercourse.
F. Installation of new or resurfaced impervious surfaces of 1,000 square
feet or more, unless prior approval of a Stormwater Management
Control Plan was received by the Town and the proposal includes
in-kind replacement of impervious surfaces.
If you answered NO to all of the questions above, STOP! Complete the Applicant section below with your Name,
Signature, Contact Information, Date & County Tax Map Number! Chapter 236 does not apply to your project.
If you answered YES to one or more of the above, please submit Two copies of a Stormwater Management Control Plan
and a completed Check List Form to the Building Department with your Building Permit Application.
APPLICANT: (Property Owner,
Design Professional, Agent, Contractor, Other)
NAME: J l� r) Yl J✓e" �C ✓ wY��
(P u
D.
Iss�.mrel
Contact Information: 6 31 -7 (O r 1' _q
telcphaie Nwnhcr'
Property Address / Location of Construction Work:
7' 0 Cer
—so LA_ n t 1�-P ily�i
FORM " SMCP - TOS MAY 2014
S.C.T.M. #: 1000 Date:
District
Section Block Lot
FOR BL!I._ .)INU DEPAR FNIIENT U.�E�t.i% IL. i
Reviewed By: (�-1 rl-,4
Date:
Approved for processing Building Permit.
Stormwater Management Control Plan Not Required.
❑Stormwater Management Control Plan is Required.
(Forward to Engineering Department for Review.)
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
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COMM,�
Telephone (631) 765-1802
96 50p 11 8 0 2
roger.richertd— offlsoult�oltl.nY.us
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
APPLICATION FOR ELECTRICAL INSPECTION
REQUESTED BY: Date:
Company Name: �' er
Name:
Ucense No.: --•�,
Address:
Phone No.:ell.
JOBSITE (NFORMATION: (*Indicates required information)
*Name:
*Address:
*Cross Street:
*Phone No.: 7 y
Permit No.:
Tax -Map District: 1000 Section: :2 9. Block: d_ Lot
*BRIEF DESCRIPTION OF WORK (Please Print Clearly)
T mV 'TL�T'S a.2 ALS. c:? [� 917TS
(Please Circle All That Apply)
Is job ready for Inspection: NO. Rough !n Final
*Do- you need a Temp Certificate: YES 1g)
Temp Information (if needed)
*Service Size: 1 Phase 3Phase 100 150 200 300 350 400 Other
*New Service: Re -connect Underground Number of Meters Change of Service Overhead
Additional Information: PAYMENT DUE WITH APPLICATION
.824Request for Inspection Form '
Town Hall Annex
54375 Main Road
P.O. Box 1179
Southold, NY 11971-0959
December 11, 2014
John Bertani Builder Inc
1380 Oakwood Dr
Southold NY 11971
BUILDING DEPARTMENT
TOWN OF SOUTHOLD
Re: Butkovich, 75 Deer Run, Southold
TO WHOM IT MAY CONCERN:
Telephone (631) 765-1802
Fax (631) 765-9502
The Following Items (if Checked) Are Needed To Complete Your Certificate of Occupancy:
NOTE: Per Building Inspector, all work required to be certified by an archite- gineer (footings,
framing, strapping) as no inspections were performed on this project.
Application for Certificate of Occupancy. (Enclosed)
✓ Electrical Underwriters Certificate.
A fee of $50.00.
Final Health Department Approval.
Plumbers Solder Certificate. (All permits involving plumbing after 4/1/84) 1
Trustees Certificate of Compliance. (Town Trustees # 765-1892)
Final Planning Board Approval. (Planning # 765-1938)
Final Fire Inspection from Fire Marshall.
Final Landmark Preservation approval.
Final inspection by Building Dept.
Final Storm Water Runoff Approval from Town Engineer
BUILDING PERMIT — 39182 — Roof Over Patio
LOT AREA = 83,771 SQ. FT.
LO
N
LOT NUMBER
4
S 8741,29..E
Choi,�link
- MENT
EN
1 pRpINAOE l
NOTE LOT CLEARING SHALL BE LIMITED TO 1 ACRE
Jv
Plastic
dper fence
298.36 1 .N J
J
FG 'N R=85.00'
x manhole L=71.75'
Covera
blkm blk curbi�.p8
to stone drivewoY
blue
BRICK 'k -4w
PASO
o NATURAL & UNDISTURBED
VEGETATION RETENTION BUFFER
N 73'05'20"W
co
R
305.6 1 '
82'
)167.6
i z67.6�
R__25.DO.
L
d-
DO
`—ter Service
0
eh
io
In
R=25.00'
NORTH BA YVIEW ROAD
NOTE: CESSPOOL, SEPTIC TANK & WATER
SERVICE LOCATIONS BY OTHERS.
THE DOSIENCE OF RIGHT OF WAYS AND OR EASEMENTS
OF RECORD, IF ANY, NOT SHOWN ARE NOT GUARANTEED.
THE OFFSETS (OR DIMENSIONS) SHOWN HEREON FROM THE STRUCTURES TO THE
PROPERTY LINES ARE FOR A SPECIFIC PURPOSE AND USE AND THEREFORE ARE NOT
INTENDED TO GUIDE THE ERMTKIN OF FENCES. RETAINING WAU_% POOLS, PATOB.
PUW,NG AREM4 ADDITION TO BUILDINGS OR ANY OTHER CONSTRUCTION.
UNAUTHORIZED ALTERATION OR ADDITION TO THIS SURVEY IS A VIOLATION OF SECTION
7209 OF THE. NEW YORK STATE EDUCATION LAZY.
GUMUNr= INDICAIM HERON SHALL RUN ONLY To THE PERSON FOR WHOM THE
SURVEY IS PREPARED. AND ON HIS BEHALF TO 1HE TITLE COMPANY. OOVERNVANTAL
AQE NCY AND LENDING INSM TION LISTED HEREON, AND TO THE ASSONEES OF THE
LENDING INSTITUTION. GUARANTEES ARE NOT TRANSFERABLE TO ADDITIONAL INSTITUTIONS
OR. SUBSEIXIENT OWNERS.
COPTS OF THIS SURVEY LMP NOT BEARING THE LAND SURVEYOR'S INKED SEAL OR
EMfi06SED $EAL SMALL NOT RE CONSIDERED TO 8E A VAUD TRUE COPY.
CERTIFIED ONLY TO:
RONALD & MARGARET BUTKOVICH
FIRST AMERICAN TITLE INSURANCE COMPANY OF NEW YORK
CITIBANK
X14
HAROLD F. TRANCHON JR. PENN. LICNNo. 21159 E
UPDATE SURVEY 10-6-2008
JOB No. 04-262 FILE No. ZOUMAS CONTRACTING j
SURVEYED FOR RONALD & MARGARET BUTKOVICH
LOT NUM
MAP OF NTRACTING CORP.
SITUATED AT BAYVIEW
TOWN OF SOUTHOLD, SUFFOLK COUNTY, N.Y.
SCALE 1" = 60' DATE 10-15-2004
FILED MAP No. 11166 DATE 10-01-2004
TAX MAP No. (REF ONLY) 1000-79—
DISK 2004
HAROLD F. TRANCHON JR. P.C.
LAND SURVEYOR
P.O. BOX 616
1866 WADING RIVER—MANOR RD. WADING RIVER,
NEW YORK, 11792
631-929-4695 -
PL -1 ,
iAjsvL4?tati
, •
APPROVED AS NOTED
ITOv+occ,
d �� - DAT B.P. # 3g,aa�
- -
X7 C- - FEE a0 BY: -
' NOTIFY BUILDING DEPARTMENT AT
- - - - 765-1802 8 AM TO 4 PM FOR THE
`_--- - ` - - - FOLLOWING INSPECTIONS:
-- - _
=-----jMra--^-------- ------------- _.—--------------------------------- --------- --- - ---- - - -- ---- - -- -- - - - - - - - - -- - - ---- --- - - - - -- - -- -- 1..FOUNDA
TION - TWO
REQUIRED
- ---- FOR POURED CONCRETE-----------
-
-Rc+a+_ROUGH FRAMING &PLUMBING
', 4
3. INSULATION
- -
___ _ _ _- .FINAL -CONSTRUCTION MUST
�f Ell'sd "t��c - - - - - -- -- -= -- _ - - BE COMPLETE FOR C.O.
(T ALL CONSTRUCTION SHALL MEET THE
REQUIREMENTS OF THE CODES OF NEW
bCt YORK STATE. NOT RESPONSIBLE FOR
- DESIGN OR CONSTRUCTION ERRORS.
COMPLY WITH ALL CODES OF
Y s NEW YORK STATE & TOWN COSECS
AS REQUIRE
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OCCUPANCY OR
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USE IS UNLAWFUL
WITHOUT CERTIFICATE
7-1 AP
OF OCCUPANCY .
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